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Shelter Medicine Externship Information Form for Participating
Shelter Medicine Externship Information Form for Participating Shelters Organization Associated Humane Societies 7/10/13 Name of Agency Date Completed 1 Humane Way (P.O. Box 43) (There is also a branch in Tinton Falls, NJ) Physical Address Forked River NJ 08731 Ocean City State Zip County 609-693-6551 609-242-1071 Agency Phone Agency Fax Website Externship Coordinator Dr. Laney Baris Shelter Veterinarian Name Title / Position 609-693-6551 none Telephone E-Mail Address Supervising Veterinarian Dr. Laney Baris Shelter Veterinarian Name Title / Position 609-693-6551 none Telephone E-Mail Address Organization Information How would you characterize the organization? Please select all that apply. ✔ Open admission / traditional shelter Municipal agency Limited admission / adoption guarantee shelter Private nonprofit agency ✔ Animal sanctuary ✔ Spay / neuter clinic Other (please describe): zoo ✔ ✔ Private nonprofit agency with government contract How many animals did the organization admit (shelter) last year? > 20,000 ✔ 1,000 – 4,999 (Tinton Falls, NJ) 10,000 – 19,999 ✔ 500 - 999 (Forked River, NJ) 5,000 – 9,999 < 500 Externship Information Please provide an overview of the externship including a brief a description of the externship objectives, agency, average number and type of animals cared for, description of facility, and responsibilities and experiences of the extern. We have a 2 week long externship for 4th year veterinary students with a focus on shelter medicine. Our shelters have an open admission and can house up to 200 dogs and 200 cats roughly between our two locations. Our Forked River facility has a dog and cat sanctuary as well as a zoo. Our externs will be expected to learn intake, adoption and preventative medicine procedures for our facilities. They will then be expected to provide these procedures to our shelter population. Externs will also participate in spay/neuter surgeries and dental procedures for shelter animals. Externs will also gain experience in ride alongs with an ACO and work in the shelter office. Proposed externship duration: ✔ Is student housing provided? 2 weeks Is a student stipend provided? Yes 4 weeks No ✔ Yes, amount: $ ✔ No Other: Please list any prerequisites for an externship at your organization. Externs must submit a resume and cover letter. How many veterinarians will the extern work with? 2 2 Full-time 6 Part-time Paid Staff Paid Contractor 1 Volunteer Do any of these veterinarians hold specialty board certification? ✔ No Yes The goal of a shelter medicine externship is to provide the veterinary student with a robust training experience in shelter medicine accompanied by exposure to the critical aspects of animal sheltering. Please fill in the attached blank calendar with a sample schedule that an extern would expect to follow at your agency. A sample week’s schedule has been provided. This is a tool only and is not considered a binding schedule. To categorize subject areas, please reference the following list. Shelter Medicine Minimum 40 hours of 80-hour externship For example: Rounds, treatments, exams, forensic cases, population management, infectious disease control, preventive health care, etc. Sheltering Operations Minimum 16 hours of 80-hour externship For example: Cleaning and disinfection, animal control officer ride-alongs, working at the shelter intake area or in adoptions, etc. Shelter Animal Surgery Up to 24 hours of 80-hour externship For example: Shelter animal spay/neuter and other surgical procedures. Time can exceed 24 hours if other minimum requirements are met. Community Medicine & Surgery Up to 8 hours of 80-hour externship For example: Public-owned animal spay/neuter, vaccinations, wellness, etc. Time can exceed 24 hours if other minimum requirements are met. Shelter Animal Behavior Optional For example: Wellness and environmental enrichment, behavior assessment, behavior modification. Please submit the completed forms and any additional documentation to: Maddie’s® Shelter Medicine Program University of Florida College of Veterinary Medicine 2015 SW 16th Avenue 100126 Gainesville, FL 32610 sheltermedicine@vetmed.ufl.edu Associated Humane Societies Agency: __________________________________________ Sample Schedule: Externship Week One Forked River Forked River Forked River Tinton Falls Tinton Falls Monday Tuesday Wednesday Thursday Friday Saturday 7:00 7:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00 8:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Shelter Rounds Supervisor: Baris Shelter Rounds Supervisor: Baris Shelter Treatments Supervisor: Baris Shelter Treatments Supervisor: Marion Treatments and exams Supervisor: Vet Tech Supervisor: Shelter Rounds Supervisor: Baris Preventative Medicine Supervisor: Baris Shelter Treatments Supervisor: Baris Shelter Treatments Supervisor: Marion Treatments and exams Supervisor: Vet Tech 9:00 10:00 Supervisor: 11:00 Shelter Rounds Baris Supervisor: Preventative Medicine Baris Supervisor: Shelter Dentals Baris Supervisor: Shelter Treatments Marion Supervisor: ACO Ride Along ACO Supervisor: Shelter Rounds Supervisor: Baris Shelter Treatments Supervisor: Baris Shelter Dentals Supervisor: Baris Preventative Medicine Supervisor: Marion ACO Ride Along Supervisor: ACO LUNCH Supervisor: LUNCH Supervisor: LUNCH Supervisor: LUNCH Supervisor: ACO Ride Along Supervisor: ACO Supervisor: Supervisor: Supervisor: 12:00 Supervisor: 1:00 2:00 Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Treatments and exams Supervisor: Marion ACO Ride Along Supervisor: ACO Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris PT for Shelter Animals Supervisor: Davis Treatments and exams Supervisor: Marion Intake Supervisor: Alicia Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Physical Therapy Supervisor: Davis Treatments and exams Supervisor: Marion Intake Supervisor: Alicia Supervisor: Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Physical Therapy Supervisor: Davis Treatments and exams Supervisor: Marion Intake Supervisor: Alicia Supervisor: 3:00 Supervisor: 4:00 5:00 6:00 Total Daily Hours 6:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 4 Medicine Sheltering 4 Shelter Surgery Community Behavior Other Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 4 Medicine Sheltering 4 Shelter Surgery Community Behavior Other Supervision 5 Veterinarian Medical Staff 3 Other Staff Subject Area 7 Medicine Sheltering 1 Shelter Surgery Community Behavior Other Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 8 Medicine Sheltering Shelter Surgery Community Behavior Other Supervision Veterinarian 2 Medical Staff 7 Other Staff Subject Area 2 Medicine 7 Sheltering Shelter Surgery Community Behavior Other Supervision Veterinarian Medical Staff Other Staff Subject Area Medicine Sheltering Shelter Surgery Community Behavior Other Supervision 29 2 10 Subject 25 7 9 0 0 0 Total Week 1 Hours 41 Tinton Falls Tinton Falls Forked River Forked River Monday Tuesday Wednesday Thursday Associated Humane Societies Agency: __________________________________________ Externship Week Two Forked River Sample Schedule: Friday Saturday 7:00 7:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00 8:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Shelter Rounds Supervisor: Marion Shelter Rounds Supervisor: Marion Shelter Office Supervisor: Cathi Shelter Rounds Supervisor: Baris Shelter Rounds Supervisor: Baris Shelter Rounds optional Supervisor: Baris Population Control Supervisor: Marion Population Control Supervisor: Marion Shelter Office Supervisor: Cathi Shelter Office Supervisor: Cathi Comm. Wellness Clinic Supervisor: Baris 10:00 Supervisor: 11:00 Treatments and exams Marion Supervisor: Treatments and exams Marion Supervisor: Shelter Office Cathi Supervisor: Shelter Office Cathi Supervisor: Community Clinic Baris Supervisor: Treatments and exams Supervisor: Marion Treatments and exams Supervisor: Marion Shelter Office Supervisor: Cathi Treatments and exams Supervisor: Baris Community Clinic Supervisor: Baris LUNCH Supervisor: LUNCH Supervisor: LUNCH Supervisor: LUNCH Supervisor: LUNCH Supervisor: Supervisor: Supervisor: Supervisor: 12:00 Supervisor: 1:00 2:00 Treatments and exams Supervisor: Marion Treatments and exams Supervisor: Marion ACO Ride Along Supervisor: Maria Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Treatments and exams Supervisor: Marion Treatments and exams Supervisor: Marion ACO Ride Along Supervisor: Maria Shelter Surgery Supervisor: Baris Shelter Surgery Supervisor: Baris Treatments and exams Supervisor: Marion Treatments and exams Supervisor: Marion ACO Ride Along Supervisor: Shelter Surgery Supervisor: Baris Treatments and exams Supervisor: Baris Supervisor: Treatments and exams Supervisor: Marion Treatments and exams Supervisor: Marion ACO Ride Along Supervisor: Maria Shelter Surgery Supervisor: Baris Treatments and exams Supervisor: Baris Supervisor: 3:00 Supervisor: 4:00 5:00 6:00 Total Daily Hours 9:00 6:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 8 Medicine Sheltering Shelter Surgery Community Behavior Other Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 8 Medicine Sheltering Shelter Surgery Community Behavior Other Supervision Veterinarian Medical Staff 8 Other Staff Subject Area Medicine 8 Sheltering Shelter Surgery Community Behavior Other Supervision 6 Veterinarian Medical Staff 2 Other Staff Subject Area 2 Medicine 2 Sheltering 4 Shelter Surgery Community Behavior Other Supervision 8 Veterinarian Medical Staff Other Staff Subject Area 3 Medicine Sheltering 2 Shelter Surgery 3 Community Behavior Other Supervision Veterinarian Medical Staff Other Staff Subject Area Medicine Sheltering Shelter Surgery Community Behavior Other Supervision 30 0 10 Subject 21 10 6 3 0 0 Total Week 2 Hours 40 Sample Externship Schedule Monday Tuesday Wednesday Thursday Johnson County Animal Services Agency: __________________________________________ Sample Schedule: Externship Week One Friday Saturday 7:00 7:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: 8:00 Shelter Rounds Supervisor: Dr. Morris Shelter Rounds Supervisor: Dr. Morris Shelter Rounds Supervisor: Dr. Morris Shelter Rounds Supervisor: Dr. Morris Shelter Rounds Supervisor: Dr. Morris Supervisor: 9:00 Exams & Treatments Supervisor: Dr. Morris Spay/Neuter Supervisor: Dr. Baxter Exams & Treatments Supervisor: Dr. Morris Staff Parvo Training Supervisor: Dr. Morris Exams & Treatments Supervisor: Dr. Bergman Supervisor: 10:00 Exams & Treatments Supervisor: Dr. Morris Spay/Neuter Supervisor: Dr. Baxter Exams & Treatments Supervisor: Dr. Morris ACO Ride-Along Supervisor: Rufus O. Exams & Treatments Supervisor: Dr. Bergman Rabies Clinic (Optional) Supervisor: Dr. Baxter 10:00 11:00 Exams & Treatments Dr. Morris Supervisor: Spay/Neuter Supervisor: Dr. Baxter Exams & Treatments Supervisor: Dr. Morris ACO Ride-Along Supervisor: Rufus O. Exams & Treatments Supervisor: Dr. Bergman Rabies Clinic (Optional) Supervisor: Dr. Baxter 11:00 12:00 Foster Treatments Supervisor: Dr. Morris Spay/Neuter Supervisor: Dr. Baxter Foster Treatments Supervisor: Dr. Morris ACO Ride-Along Supervisor: Rufus O. Foster Treatments Supervisor: Dr. Bergman Rabies Clinic (Optional) Supervisor: Dr. Baxter 12:00 1:00 Foster Treatments Supervisor: Dr. Morris Forensic Exams Supervisor: Dr. Bergman Foster Treatments Supervisor: Dr. Morris ACO Ride-Along Supervisor: Rufus O. Foster Treatments Supervisor: Dr. Bergman Supervisor: Supervisor: 2:00 3:00 4:00 Supervisor: 8:00 9:00 1:00 2:00 Behavior Assessment Supervisor: Maria S. Forensic Exams Supervisor: Dr. Bergman Foster Treatments Supervisor: Dr. Morris Shelter Intake Supervisor: John K. Adoptions Supervisor: Janice C. Behavior Assessment Supervisor: Maria S. Forensic Reports Supervisor: Dr. Bergman Monthly Stats Review Supervisor: Dr. Morris Shelter Intake Supervisor: John K. Adoptions Supervisor: Janice C. Behavior Assessment Supervisor: Maria S. Forensic Reports Supervisor: Dr. Bergman Monthly Stats Review Supervisor: Dr. Morris Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: 3:00 Supervisor: 4:00 5:00 5:00 6:00 Total Daily Hours 6:00 Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervisor: Supervision 6 Veterinarian Medical Staff 3 Other Staff Subject Area 6 Medicine 3 Sheltering Shelter Surgery Community Behavior Other Supervision 9 Veterinarian Medical Staff Other Staff Subject Area 5 Medicine Sheltering 4 Shelter Surgery Community Behavior Other Supervision 9 Veterinarian Medical Staff Other Staff Subject Area 9 Medicine Sheltering Shelter Surgery Community Behavior Other Supervision 2 Veterinarian Medical Staff 6 Other Staff Subject Area 2 Medicine 6 Sheltering Shelter Surgery Community Behavior Other Supervision 6 Veterinarian Medical Staff 2 Other Staff Subject Area 6 Medicine 2 Sheltering Shelter Surgery Community Behavior Other Supervision 3 Veterinarian Medical Staff Other Staff Subject Area Medicine Sheltering Shelter Surgery 3 Community Behavior Other Supervision 35 0 11 Subject 28 11 4 3 0 0 Total Week 1 Hours 46